[Health literacy: Definition, assessment tools, state of the art in Europe, health consequences and ways to improve it]. / La littératie en santé : définition, outils d'évaluation, état des lieux en Europe, conséquences pour la santé et moyens disponibles pour l'améliorer.

The term "littératie" is derived from the English word "literacy", which refers to knowledge and skills in the fields of reading, writing, speech (or other means of communication) and calculation that allow people to be efficient and integrated into society. Health literacy is a recent concept that relies on the ability to find, understand, evaluate and communicate information in ways that promote, maintain and improve the health of the individual in various settings over the course of life. The objectives of this review are first of all to realize an overview on the health literacy of populations in Europe. Then, we propose to study the link between health literacy and health status (risk behaviors, chronic diseases, morbi-mortality, adherence to care and medical monitoring) and to study its medico-economic impact. We also analyzed the association between personalized therapeutic education and health literacy. Finally, we propose a review of the means put in place in the care system to improve the health literacy of the patients we manage.

[The shared educational assessment in the smoking cessation process]. / Le bilan éducatif partagé dans le processus de sevrage tabagique.

In the context of smoking cessation, the shared educational assessment (BEP) enables us to assess the smoker's needs, define specific objectives and set up appropriate educational workshops. This multidisciplinary approach helps smokers to maintain their smoking cessation. The BEP is the first step in the educational process, exploring the various classic dimensions of therapeutic patient education (TPE) and then defining an action plan based on the priorities identified.

[Quantitative and qualitative evaluation of a specific grid of head and neck post-cancer with user healthcare professionals]. / Évaluation quantitative et qualitative d'une grille spécifique de l'après-cancer des voies aérodigestives supérieures auprès des professionnels de santé utilisateurs.

INTRODUCTION: The post-cancer period is a delicate one, as it does not necessarily mean good health and/or a return to life as it was "before". Over the past twenty years, a number of initiatives have been launched to improve support for people after cancer. We have created a post-cancer care pathway for patients with head and neck cancer, based on a nursing interview and the use of a post-cancer grid. MATERIALS AND METHODS: The steps involved in creating the pathway and the grid, the fruit of a working group involving the educational team, five patient associations and two expert patients, with the support of a health promotion engineering resource association, were explained. A quantitative and qualitative evaluation of the use of the grid was carried out. RESULTS: Sixty-five patients benefited. Individual interviews with the nurses involved in the post-cancer process showed that the grid was complete, easy to follow and based on the semi-directive interview model, but that care had to be taken not to follow it to the letter, so as not to impair the quality of the interview. CONCLUSION: Our post-cancer approach for upper aerodigestive tracts, anchored in a dedicated grid, highlights the often underestimated significance of this crucial phase in patients' journeys. While the grid is a valuable tool in development, its use requires caution, with further research needed to confirm its effectiveness. We encourage adaptation by teams, respecting fundamental principles.

[Prehabilitation in chronic inflammatory bowel disease: the Proactive care pathway]. / Préhabilitation dans les maladies inflammatoires chroniques de l'intestin : le parcours de soins Proactive.

Inflammatory Bowel Diseases (IBD) cause diarrhea and abdominal pain that impair quality of life. Digestive damage frequently leads to undernutrition and sarcopenia, which worsen the prognosis of the disease. This led to the development of PROACTIVE, a multimodal prehabilitation program designed to improve the functional capacities, nutritional status and quality of life of IBD patients. 19 patients have been included in our pilot program, with an initial personalized multimodal assessment, 10 group sessions with 4 patients, and a final multimodal assessment proposing personalized care for home. Initial data are positive, showing an improvement in patients' physical capacity and quality of life after 6 weeks.

[Optimizing the management of heart failure: structuring the care pathway]. / Optimisation de la prise en charge de l'insuffisance cardiaque : structuration du parcours de soins.

The incidence of chronic heart failure continues to rise in Western countries, justifying the implementation of an optimized multidisciplinary organization based on medical and nursing convergence. Around the main heart failure, assistance and transplantation unit at Toulouse University Hospital, several structures have been put in place to better manage heart failure patients and improve their care pathway.

[Taking into account the link between health and the environment]. / Prendre en compte le lien entre santé et environnement.

Because of their weight and size, children are much more sensitive to environmental pollution than adults. They breathe, drink and eat more, and therefore absorb more potentially toxic substances, as the European Environment Agency points out. Challenges therefore lie ahead in a number of areas. As soon as pregnancy is announced, prevention and awareness-raising workshops are offered at the three Trousseau-Tenon-Pitié-Salpétrière maternity units of the Sorbonne Université-Paris hospital group of the Assistance publique-Hôpitaux de Paris. If a child is suspected of having food allergies and/or requires medical attention, the paediatric allergology department of the Armand-Trousseau hospital in the 12th arrondissement will be contacted.

[Current issues surrounding Parkinson's disease]. / Enjeux actuels autour de la maladie de Parkinson.

The number of people suffering from Parkinson's disease is constantly increasing. Diagnosis is based on the motor and non-motor symptoms present throughout the course of the disease. To preserve patient autonomy, the main therapeutic challenge is to propose a treatment adapted to each profile, in conjunction with the implementation of non-medication strategies, reflection on improved accessibility to existing medication and research into innovative therapies.

[Nurse coordinators and IPAs in Parkinson's expert centers: what are their roles?] / Infirmières coordinatrices et IPA en centre expert Parkinson : quels sont leurs rôles ?

The creation of Parkinson's expert centers (PEC) led to the emergence of new nurses, known as coordination nurses. And in 2018, the emergence of advanced practice nursing led to the creation of a new category of professionals, advanced practice nurses (APN). Nurses coordinators and APN play a major role in meeting the public health challenges posed by Parkinson's disease. They are the guarantors of the implementation of a personalized care pathway, the aim of which is to offer patients an optimized quality of life. They forge an indispensable link between the city's healthcare services and the PEC, collaborating with the many healthcare professionals who work with people suffering from Parkinson's disease.

[Children with atopic eczema and their environment]. / L'enfant atteint d'eczéma atopique et son environnement.

Taking an interest in the environment of a child suffering from eczema means understanding the word "environment" in the broadest possible sense: the child's lifestyle, family, social and cultural environment. By taking all these aspects into account, we can optimize the effectiveness of treatments, and avoid the multiple problems and comorbidities associated with moderate and severe eczema. It's up to caregivers to be vigilant about this, and to reposition the right gestures by spotting errors right from the start, even in the case of mild eczema. The best way to respond to this challenge, i.e. to help parents understand, is to draw on the principles of therapeutic patient education.

[Perspectives on quality of life with endometriosis]. / Perspectives de la qualité de vie avec l'endométriose.

For women with endometriosis, pain, fatigue and digestive problems affect the quality of their daily lives. Many professionals work to help them find a balance between the disease and their activities, expectations and needs.

[Interest of a short educational intervention coordinated by community pharmacists for elderly type 2 diabetes patients in a rural area]. / Intérêt d'une séance éducative « flash ¼ coordonnée par des pharmaciens d'officine pour des patients âgés diabétiques de type 2 en milieu rural.

The number of elderly people with type 2 diabetes (T2D) is increasing worldwide. Community pharmacies, thanks to their proximity, provide more easy access to therapeutic education for rural patients. Populations living in isolated areas require specific educational resources related to their condition. The aim of this project was to perform a short (FLASH) educational intervention, coordinated by community pharmacists, and then evaluate the impact of this intervention on patient knowledge of their disease. The study was performed in Issoudun, a rural French town of approximately 10,000 inhabitants. Educational priorities were defined and the project was presented to health authorities and local health professionals. Pharmacies in Issoudun recruited patients, either alone or accompanied by their caregivers. The educational intervention lasted 2h and focused on 4 teaching objectives: knowledge concerning diabetes, diabetic complications and how to monitor them; how to react to hypoglycemia; understanding treatments; and understanding glycated hemoglobin. The impact of this educational intervention was assessed using a questionnaire delivered before the intervention, immediately after, and after 6months. Forty-five patients aged 71±6years with T2D duration of 14±6years were recruited over 6months. Some false beliefs were identified before the intervention. The educational session led to a significant improvement in the percentage of correct answers (before: 60.3%±7.5, after: 99%±0.4, P=0.0002) and at 6months (99.5%±0.3, P=0.0002) compared with the patients' initial knowledge. Almost all false beliefs were corrected by the intervention and patients were able to recall the mechanism of action of their drugs, with the help of a "key and lock" schematic. This short FLASH educational intervention, coordinated by community pharmacists, showed that the model was both interesting to patients and effective. This method could be expanded to other rural communities and medical deserts.

[Development of a targeted educational activity in addictology: From design to use in specialized structures in the Normandy region]. / Élaboration d'une activité éducative ciblée en addictologie : de la conception à l'utilisation dans les structures spécialisées de la région Normandie.

OBJECTIVE: Risk and damage reduction is a public health issue and allows to consider addiction as a chronic pathology in which patients have the opportunity to become actors of their own care, a philosophy shared with Therapeutic Education. In this context, our objective is to develop a tool adapted to the populations of patients/users in specialized structures, meeting the criteria of a Targeted Educational Activity, to allow them a better understanding and management of their addiction to opiates on a daily basis. METHOD: In a multi-professional setting, involving pharmacists, doctors and nurses, an exploratory phase was conducted in order to identify the theme, the target population and the tool format. Then, the tool was built and validated with the ambition of responding pedagogically to the problems encountered daily by patients/users. RESULTS: The pedagogical tool, called "Le QUIZZ à moindre risque", contains 51 questions categorized in 2 structured parts on the reduction of risks related to opiate consumption and substitution drugs. Focused on the problems of patients/users, it helps them achieve greater autonomy in their health and a better quality of life, with and despite the illness. The proposed format makes it a tool that can be freely consulted by patients/users according to their practices and needs; it can also be used in group workshops conducted with the caregivers. CONCLUSION: The tool developed aims to (i) enable opiate users to acquire skills to improve the management of their consumption and the risks involved and (ii) strengthen communication between patients/users and caregivers by offering them the opportunity to be actors of their care. The tool is currently being tested and evaluated in many cities in Normandy and its optimization will allow for an improvement in care that meets the challenges and needs.

[Information sources and therapeutic education in autoimmune bullous diseases]. / Sources d'information et éducation thérapeutique dans les maladies bulleuses auto-immunes.

Finding information about diseases and their treatment can be useful for healthcare professionals, patients and their families. The Internet has made it easy to find information on rare diseases. However, it is sometimes difficult to select useful and accurate data sources. One of the roles of reference centers and patient associations is to provide appropriate, high-quality information. Another of their aims is to develop therapeutic patient education to improve quality of life.

[Hygiene care and local treatment of skin and mucous membranes in autoimmune bullous diseases]. / Soins d'hygiène et traitements locaux de la peau et des muqueuses dans les maladies bulleuses auto-immunes.

As part of its therapeutic patient education program, the Avicenne hospital in the Paris region invites patients with an autoimmune bullous disease to a workshop dedicated to local skin and mucous membrane care. Together, a nurse, patient partners and patients review best practices in hygiene care and treatment of the skin, eyes, nose, mouth, genitals and anus. This is essential for healing lesions and avoiding local complications.

[History and challenges of the transition from pediatrics to adult care]. / Histoire et enjeux de la transition pédiatrie-soins d'adultes.

Transition from pediatrics to adult care involves a growing number of young people living with chronic health conditions. Now a field of study and practice, transition has been built up in successive stages, the nature of which informs us about its evolution and current issues.

[A day in the pediatric day hospital: towards a successful transition]. / Une journée en hôpital de jour pédiatrique : vers une transition réussie.

Medical advances now enable children with chronic illnesses to live better and longer. As a result, the transition from adolescence to adulthood is increasingly being addressed in pediatric wards, with the aim of optimizing continuity of care. This was achieved at the pediatric day hospital at the Centre hospitalier intercommunal de Poissy-Saint-Germain-en-Laye, near Paris.

[The city-hospital link in the care of severely obese patients]. / Le lien ville-hôpital dans le parcours de soins des patients obèses sévères.

After the initial weekday hospital stay, a personalized, multidisciplinary care pathway is offered to each patient followed at the specialized obesity center (CSO). This article illustrates the support approach adopted by the CSO at Caen Normandy University Hospital.

[Associations to promote access to care and recognition of obesity]. / Des associations pour favoriser l'accès aux soins et la reconnaissance de l'obésité.

Patient associations bring many benefits to people suffering from obesity. What's more, through their actions, these associations contribute to the recognition of obesity as a pathology.

[Empowering patients suffering from chronic pain]. / Rendre son pouvoir d'agir au patient souffrant de douleur chronique.

Living with chronic, daily pain generates a variety of reactions for every individual. To provide the best possible support for sufferers, management strategies have diversified, becoming multimodal and encompassing pharmacological, non-pharmacological, psychological, physiotherapeutic and educational therapies. It is within this framework that therapeutic patient education, hypnoanalgesia and self-hypnosis have been deployed.

[Smoking cessation treatment for smokers with COPD: The importance of therapeutic education]. / Sevrage tabagique du patient atteint de BPCO : importance de l'éducation thérapeutique.

Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD). The diagnosis of tobacco addiction and management of tobacco dependence are part and parcel of COPD treatment, especially in respiratory rehabilitation. Management encompasses psychological support, validated treatments and therapeutic education. The objective of this review is to briefly recall the guiding principles of therapeutic patient education (TPE) as it applies to smokers wishing to quit and, more specifically, to present the tools conducive to shared educational assessment and treatment according to the Prochaska's stages of change model. We are also proposing an action plan and a questionnaire through which TPE sessions can be assessed. Finally, culturally adapted interventions and new communication technologies are taken into consideration insofar as they constructively contribute to TPE.